prescribing the symptom

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Permalink Reply by Neil on July 14, 2009 at 2:41am

Hi Grumps,

You said,
a) what if the suggestion only is put into effect half-way, meaning that the client increases their negative behavior as suggested... but never gets to the point where the negative behavior becomes uncomfortable enough to be the target of "resistance".

Neil says:
The negative behaviour is undesired by the client. This is why she/he is with you.
Establish the unwanted emotional response the client feels. E.g. "I hate being fat".
Increase it to the point of "over-whelming" disgust, dislike etc..

Increase the negative feelings towards the behaviour, not the behaviour.

You said,
b) how would client feel about this sort of tactic? might not they get kind of confused and irritated that a hypnotist is telling them to increase their negative behavior or feelings? but if the rationale behind this tactic is explained to them, that would seem to cancel out the possible effectiveness of it.

Neil says,
Establish the belief in the client that we act on feelings: towards and away.
If she/he wishes to move away from the behaviour, then he/she must set up the feelings needed to do so.
Resistance is just lack of understanding, either on the hypnotist's side or that of the client.

You said,
Another reason I am uncertain of this approach, although I can imagine it being valuable, is that maybe it is more appropriate for someone with a more thorough counseling/therapeutic relationship and background (like Erickson), someone who is equipped to handle possible unintended effects, rather than someone like me who is "just" a hypnotist? Or maybe I am just wimping-out.

Neil says,
Stop talking shit!
I'd rather go to you than a therapist any day.

You said,
What dost thou thinkest of this matter?

Neil says,
It's a good job there are people like you who think!

Love and respect Neil

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Permalink Reply by Michael Ellner on July 14, 2009 at 4:25am

Hi Grumps, et al.

I think uncle Miltie was "prescribing the symptom" with the intention of using the behavior as resource state--

Example-- suggesting to a hypnotized procrastinator that they will be easily be able to over come the unwanted behavior because the next time that they have an impluse to procrastinate they will automatically put it off...

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Permalink Reply by Joe K Fobes on July 14, 2009 at 4:34am

a) If the client listens only half way then we are where we want to be. We can use the difficulty they had in doing the behavior and build off that. We finally have an example in their life how they hated eating or how they couldn't procrastinate any more.

b) Explain to the client that we are developing rapport with the part of them that's doing the problem. We will give it exactly what it wants and more :)

I don't think that the tactic is simply "have them get so fat that they hate it". I see this tactic in the broader sense of establishing boundary conditions to the problem.

When clients feel "out of control", what they are saying is that there is a part of them that has no boundaries or limits and does not conform to the usual decision making process inside of them. Thats a lie. This helps them see that lie clearly.

"I can't not eat! I just can't!" That's a lie. We will help them see that they can not eat so badly that they get disgusted at the thought of eating.

When I get a client with food issues I fight with them and ask them why they want to eat less. After all, eating is so enjoyable. They tell me the benefits (health, looking good), but I persist that the taste of the food is worth more, and have them convince me that the taste of the food isn't worth it.

Gotta run, if I'm not making sense let me know and I'll fix it laters.

Joe

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Permalink Reply by James Hazlerig - HypnosisAustin on July 14, 2009 at 6:46am

I think the point of prescribing a symptom is two-fold: First, it motivates the client by making the symptom onerous. Second, it proves that the client has control of the symptom.

I don't generally use prescribing the symptom as my overall approach, but sometimes with pain management I'll briefly have the client turn up the pain before turning it down, purely to demonstrate that pain can be controlled. Likewise, when I establish a sliding anchor for something pleasant, I turn it down before turning it up.

The other thing that Erickson could do was set challenges his clients had to get passed before he would work with them. (Oh, to have that luxury . . . ) For instance, he told a woman who wanted to lose weight that he wouldn't help her till she gained more weight. That was a case of prescribing the symptom. But he told another client that he wouldn't work with her until she had hiked to the top of a local hill. When his students asked why he did that, he replied, "So I could be sure she'd obey me."

(Funny when we think about how "non-authoritarian" and "permissive" Ericksonian hypnsosis is, huh?)

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Permalink Reply by Susan French on July 14, 2009 at 8:16am

Me thinkest that I would leave a tactic like that to Erickson.

What might work in a similar vein, though, would be to suggest in hypnosis that the client become hyper-aware of those feelings and hyper-aware of the messages in the feelings (i.e. the resistance) and then choose an alternative behavior that is more productive and anchor it in. I've done that quite successfully with weight loss clients.

I suggest to them that they will become very aware of their feelings every time they want to eat. If the desire to eat is for anything other than fueling, I suggest that they will become very aware of the feelings and the message (I feel edgy, I want to eat to relieve the edginess, I'm edgy bc I'm angry at my spouse for xxxxx. I would rather .

Perhaps that might work without risk. (I use Cal Banyan's Secret Language of Feelings to help them decode the feelings).

Susan

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Permalink Reply by Jason Keen on July 14, 2009 at 8:16pm

I'm sure it has more to do with what everyone else is saying here, but, I wonder if it's possible that this is just good old fashioned "reverse psychology".

I have found in my personal sessions (in the chair) that, if I'm not in a deep trance, I've often regressed to a "younger" state, where my rebellious mental aspect is slightly engaged. My critical factor becomes reactive to suggestions.

I could see how prescribing the symptom might elicit an "F-you" from one's inner Rebel, switching the Rebel's intent to favor what is actually good for the client - like telling a youngster "I bet you can't finish all that food on your plate..."

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Permalink Reply by Jack Hirsh on July 15, 2009 at 4:49am

I wonder if this technique could be used in a hypnotic progression (rather than regression). I believe Cal Banyan uses something similar to this when he does his fork in the road technique. He has the client mentally standing at a fork in the road where one road represents how their life will be if they continue with the same old bad habits they have had for years. He will take them 5 years down the road, 10 years down the road, etc. It seems to me that at this point you could do as Grumpy says and build this feeling to the point the client is absolutely miserable (they are probably pretty close to miserable since they are sitting in a hypnotists office).

Then you can take them down the other road. This road obviously representing their life with the required changes and show them how good their life could be by making the changes.

It seems to me that this technique while slightly different from Erikson’s may be “safer” for those of us that are “just” hypnotists.

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Permalink Reply by Steve Andrade on July 15, 2009 at 4:50am

Hi all,
When Erickson instructed the lady who wanted to lose weight to gain 15 pounds first, that was to remind her unconscious that she has control over her eating, it wasn’t to get her pissed off at being fat.

When symptoms are prescribed, I think that is under the solution orientated therapy process which one way is by using the skills and the talents that created the problem to also solve the problem. As with the procrastinator's suggestion to procrastinate procrastination.

It is beautiful, because you don’t have to teach them anything, they already have the skill, you just reassign the skill’s mission by conditioning the mind to think of a better solution than the solution it has been using, (this also eliminates a suggestion that sounds good to us but might not be accepted by the client, as in a pre written script for general purposes).

Erickson used metaphors beautifully to accomplish this task, metaphors whose context had nothing to do with their symptoms but included the framework for the change based on the minds desire to complete, or fill-in-the- _ _ _ _ _ _.

Enjoy,
Steve

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Permalink Reply by Donna Carter on July 15, 2009 at 6:32am

Some people who have anticipatory anxiety... benefit from 'prescribing the symptom'.

Example: have the client look forward to feeling the anxiety and using that time to monitor what it feels like, so as to come back and report the actually feelings while in a 'investigator' role.

What happens is that... the anticipatory anxiety doesn't thrive because the whole reason it was there was because of the 'fear of it happening'. When that fear is gone... so then, is the anticipatory anxiety.

~D.

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Permalink Reply by Steve Andrade on July 15, 2009 at 9:01am

Hi Jack,

Jack Hirsh said:

He has the client mentally standing at a fork in the road where one road represents how their life will be if they continue with the same old bad habits they have had for years. He will take them 5 years down the road, 10 years down the road, etc. It seems to me that at this point you could do as Grumpy says and build this feeling to the point the client is absolutely miserable (they are probably pretty close to miserable since they are sitting in a hypnotists office).

Then you can take them down the other road. This road obviously representing their life with the required changes and show them how good their life could be by making the changes.

It seems to me that this technique while slightly different from Erikson’s may be “safer” for those of us that are “just” hypnotists.

I'm not really sure if misery is the goal for change, I would like to think that it just acknowledges the fact that what the client is doing is something they really don't want. As Dr. Phil puts it, "you can't change what you don't acknowledge," and this forces someone to see this and it now conditions them and readys them for change.

I love the fork in the road and when you take them down the road of choice you can even have them or yourself describe the outcome goal and the really cool part once the outcome is established is to then ask them questions like, "and how will you know when you've reached this goal, what will it look like, what will you feel, what would be something that will take place where you can then say, I'm here, and what are some of the changes you would be able to look back and see that got you to this goal?"

Their answers to you would be the suggestions that you could feed back to them in hypnosis and these suggestions would automatically be accepted as they came from their own inner mind.

Good luck,
Steve

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Permalink Reply by Fable Goodman on July 15, 2009 at 1:38pm

I like this response Steve.

In addition, I like to have all the paths lead to the same positive future.

Belt and braces!

LOve and hugs,

Fable

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Permalink Reply by Mark Tyrrell on July 16, 2009 at 3:35am

Hi

I think one benefit of prescribing the symptom is that it takes pressure off the client (and therapist?) as with the classic sex counselling task of instructing a man experiencing impotence to lie naked with his lover but "not to get an errection!" Failure becomes sucsess and sucess failure. It may not instantly cure the problem but it can loosen it's inflexibility as a productive start.

Establishing rapport with some clients may be done by NOT trying to ‘take the problem away’. People often seem to be ‘split’ in that an unconscious part of them wants to keep the problem behaviour (it may be meeting unconscious needs or be reassuringly familiar) and part of them doesn’t want the problem - the conscious part.

Sometimes, to really ‘join’ the client in their reality we can "encourage the problem", thus taking away pressure to change. This, paradoxically, lets you work with the ‘problem part’ by coming alongside it, rather than by trying to confront it head on. Instead of “I’m going to take your problem away...” the message can sometimes be “You can keep your problem but…”

I recall a young woman who was terrified of "making mistakes" in public. Such as? Tripping and falling on the pavement (side-walk) and having strangers laugh. I convinced her to purposefully fall as a "task". It took her one hour of walking up and down, finally she purposefully tripped up in a busy mal and....no one paid any attention, a bit annoyed she did it again and again nothing but bystander apathy...eventually a little old lady asked her if she was alright....

So from prescribing the symptom:
We went to her trying to do what she feared she wouldn't be able to help doing
To doing it and discovering the reality was very different from the feared imagination
To actually resenting the fact that (most) people ignored it altogether.

She just couldn't think or feel about this in the same way after this piece of behavioural therapy

Mark

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